Loading...
HomeMy WebLinkAboutDickerson (2) OfIrecIlA l ,054 :0;sh ' € rTI �,, Town Hall, 53095 Main Road P.O. Box 1179 � Southold, New York 11971 JUDITH T.TERRY 62 . ',• TELEPHONE ��/��/ (516) 765-1801 TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL PERMIT OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. 816-R Residential X Non-Residential Fee $ 10. 00 Septic Cesspool X New Existing X Name Of Owner DICKERSON, BRIAN L. Mailing Address 1 2575 SKUNK LANE Mailing Address 2 City St Zip CUTCHOGUE NY 11935-0000 Property Address 1 2575 SKUNK LANE Property Address 2 City St Zip CUTCHOGUE NY 11935-0000 Owner Telephone No. 516-734-5881 Tax Map No. section 97. 00 block 4 lot 13 . 000 Cross Street EUGENES ROAD Date Of Last Pump Out 0/00/00 Issue Date: 9/06/88 Judith T. Terry Southold Town Clerk (TOWN SEAL) '' „ '•'' QFF.i'C;E OF THE TOWN CLERK FOUr r Town of Southold � CQ Application_ No. a /� Judith T. Terry, Town Clerk L"') Residential �✓ Town Hall, 53095 Main Road c "`,� - , p. O. Box 1179 u' '' � �,�Y- ' �� Non-Residential Southold, New York 11971 O ®4ttr' so*.�� Telephone 10 i. 1 .1• (516) 765-1801 TOWN OF SOUTHOLD SOUTHOLD WASTEWATER DISPOSAL DISTRICT APPLICATION for OPERATION PERMIT SEPTIC TANK or CESSPOOL Operation Permit No. Fee $ (09 DATE 6 Ml OWNER NAME: 4 L, OWNER MAILING ADDRESS: 0�57 5 S\-01\A_ Let-avl; 06-, 9,,i . W55 OWNER PROPERTY ADDRESS: 5, OWNER TELEPHONE NUMBER: '734-- TAX 73 `t--TAX MAP NO. : Section \ 00 0 —q-3Block 0 T Lot t 3 CROSS STREET: C Gt S c TYPE OF SYSTEM: Septic Tank New Existing Cesspool , New Existing Residential Non-Residential DATE OF PREVIOUS PUMP-OUT: LOCATION MAP: Must be attached hereto before permit may be issued. (Locate building and system; give north arrow and feet of distance, approximately, to building and closest road.) L� {. Signature of Applicant RECEIVED BY: Town Clerk's Office DATE: • N - -.-- 4 . .... ow N/F12( '-'7 Fpk,- ,...00-:vil it JA LyrNO I7U 09 ( G 169' FE -• S : '. Ailimir s. I..VS QI 3 APR QI ---------------------t -... N .-- o , s I Ew., .. . N15° 6'2°2 APRON ...----------- PIPE FRO FE 0 4..9 C...) 72E ..10 Ct. 0. i - 3 36 -,.e. 0 t.-----4 - 511.1,06- /----ivigEs . - - IA ,r--------1 \ 2,s. . r —J Lis .0 __ / 420 0. '1,136 , G . • 41116AP ' .1:4 . _ 1 ..Q• 614 10- - 'CO ' RY 0 4\ - !-t '13) . zatT. r...,_ - /0N‘' . 4o• 7. _ - 0 , / +17 - 3. „7"iii 0' FE '. 05'S CO 214 1,4 If -z_ O./.£ 0 01 C.61 OP..1 1,.. . *•.. '1 O . . <I , - -- \ C 1091 5 . . . 4..1%. ' .941.44•1 1..'' • - i --br ,„..•' s 1.. 0.„ -.* , . i cl•-• 1 7-)-3-14,..,:;...,r1.-7.--.. . . A:••• f' +0 -1,C) (Is 0 492 <e.,• 4 ,. kb s‘)C LAND MAP OF CER TIF/ED TO LONG ISLAND SAVINGS BANK DESCRIBED PROPERTY EQUITY ABSTRACT, /NC - . - . SITUATED AT FOR: BR/AN L.DICKERSON . . BARBARA A. DICKERSON- _ . -, , _ pEcoNic . , _ TOW'N' ':0E-SOU:T1404-0 -:--- - -:-::', :,., ,r, i , = --:*-''-- --- ' sea an _ , -- -' -' ' ---- -- --------- ' -- '- -------------- - - ----.-- -- ,, -- , --.--- -, : - - surveying.-,-_. ___'.- „-,_ __:, -:„ -..: .-. -_--- -- '''-engineering.---.._--RG --. ---,::- - -' '1 - -' . - ------2-- - --A- --- - '' ' '-- - ---- -- -rr- - ' --: -----'- - 0--.,'WeSt-:mdin _Stret -----_----- ;., -- _ ..._ , _ tiverhead new _york-,J19Q1 . _ - - - - : - -' - ' --' -'- ---' - • -= -7 -, ---(5 16) 369, - 1717 . . May 6, 1986 ' -:__-==-___- -Jab N9 86-1252 , - - ---cr AREA 19,570 SQ 14A ----1 -': -- `-'' ' - '-- - ---- -' 100097:-04-13-_, - ' _Stale: 1-1,-- 30' ' FT 0-4- .7`A 'es) ' -- _-_ ' -,- ,-